Drug Utilization Pattern of Antihypertensive Agents in a Tertiary Care Hospital

Introduction Hypertension constitutes a significant global health challenge and is a major contributor to cardiovascular morbidity and death, particularly in economically developing nations. Although effective antihypertensive medications are widely accessible, satisfactory blood pressure regulation is often not achieved due to suboptimal prescribing practices. Periodic evaluation of how medications are prescribed and consumed in clinical practice is therefore necessary to bridge existing gaps and guide improvements in patient care. The primary objective of this study was to evaluate the drug utilization pattern of antihypertensive medications among hypertensive patients attending the outpatient department of a tertiary care hospital. The first secondary objective was to assess antihypertensive prescribing patterns in relation to World Health Organization (WHO) core prescribing indicators. The secondary objective was to examine adherence to the National List of Essential Medicines (NLEM) 2022 of India. Methods A cross-sectional observational study was conducted among 99 patients diagnosed with hypertension visiting the outpatient clinic of a tertiary care hospital over a period of 18 months, from March 2024 to August 2025. Patient information including sociodemographic characteristics, total number of medications prescribed, therapeutic drug categories and individual agents, dosing parameters, duration of antihypertensive treatment, and utilization of fixed-dose combinations (FDCs) were systematically documented. Medication use was assessed utilizing the standard WHO core prescribing indicators, and evaluation of medications sourced from the essential drug list was done using the NLEM 2022 of India. Results A total of 58 (58.6%) patients belonged to the ≥60-year age group, and 52 (52.5%) were males. Monotherapy was the most commonly prescribed treatment, accounting for 39 (39.4%) patients, followed by FDCs in 38 (38.4%) patients. Calcium channel blockers (CCBs) emerged as the most widely utilized drug class, prescribed in 65 (65.6%) patients. Among monotherapy recipients, CCBs and angiotensin receptor blockers (ARBs) were the predominantly used agents, accounting for 22 (22.2%) and 14 (14.1%) patients, respectively. Among free drug combinations, CCBs with ARBs were the most common, prescribed in 10 (10.1%) patients. Among FDCs, CCBs with ARBs were the most commonly prescribed in 11 (11.1%) patients, followed by CCBs with beta-blockers in seven (7%) and ARBs with diuretics in six (6.1%) patients. The mean number of drugs per prescription was 1.4±0.6, and 79 (58.9%) medications were drawn from the NLEM. Conclusion Antihypertensive prescribing patterns were broadly consistent with guideline-preferred first-line drug classes, with CCBs and ARBs as the prominent agents. A substantial proportion of medications were drawn from the NLEM, though the proportion prescribed outside the NLEM highlights the need for ongoing prescription monitoring. Periodic evaluation of antihypertensive prescribing trends in tertiary care hospital settings is recommended to inform quality improvement initiatives in hypertension management.